Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardiac > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

What causes S1 sound?

A

Closure of mitral and tricuspid valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes S2 sound?

A

Closure of aortic and pulmonic valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What might an S3 heart sound suggest?

A

Congestive heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What might an S4 heart sound suggest?

A

Poor ventricular compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Location for auscultating aortic valve sounds?

A

Right sternal border at 2nd intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Location for auscultating pulmonic valve sounds

A

Left sternal border at 2nd intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Location for auscultating mitral valve sounds

A

Left midclavicular line at 5th intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Location for auscultating tricuspid valve sounds

A

Left sternal border at 4th intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Heart sound that marks onset of systole

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Heart sound that marks the onset of diastole

A

S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Heart sound that marks beginning of isovolumic contraction

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Heart sound that marks beginning of isovolumic relaxation

A

S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Heart sound is louder with vigorously contracting ventricle

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Heart sound is softer with poorly contracting ventricle

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heart sound is louder with hypertension

A

S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Heart sound is softer with hypotension

A

S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is S3 heard?

A

During middle 1/3 of diastole- after S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes S4 heart sound?

A

Atrial systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is S4 heard?

A

Before S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What part of the stethoscope is best for listening to high pitched sounds (S1, S2, regurgitation)?

A

Diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What part of the stethoscope is best for listening to low pitched sounds (S3, S4, mitral stenosis)?

A

Bell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of valvular lesion results in concentric hypertrophy?

A

Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Valvular, fixed obstruction to forward flow

A

Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Valvular lesion- turbulent blood flow, higher velocity of travel

A

Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Cardiac compensation in which sarcomeres are added in a parallel fashion and the wall chamber becomes thicker > reduces chamber radius
Concentric hypertrophy
26
Incompetent valve
Regurgitation
27
Valvular lesion- some blood flows forward and some blood flows backward
Regurgitation
28
Valvular lesion- volume overload
Regurgitation
29
Heart compensates by adding sarcomere in series > chamber radius increases
Eccentric hypertrophy
30
Normal aortic valve area
2.5- 3.5 cm2
31
Aortic valve area in severe aortic stenosis
≤0.8 cm2
32
Etiologies of aortic stenosis
Bicuspid aortic valve Rheumatic fever Infective endocarditis
33
Compensatory mechanisms of aortic stenosis
Increased thickness of the left ventricular wall Decreased compliance Smaller chamber radius
34
Presentation of aortic stenosis
Syncope Angina Dyspnea
35
Anesthetic goals for aortic stenosis
HR: Avoid tachycardia Rhythm: NSR (maintain atrial kick) Preload: Increase Afterload: Maintain or increase Contractility: Maintain Pulmonary vascular resistance: Normal
36
Anesthetic considerations for aortic stenosis
Avoid spinal anesthesia in patients with severe aortic stenosis Chest compressions often ineffective
37
Arterial waveform of aortic stenosis
May show: Pulsus tardus Pulsus parvus
38
Transvalvular pressure gradient in aortic stenosis
>40 mmHg
39
Wall tension in aortic stenosis (increased or decreased)
Increased
40
EDV and ESV in aortic stenosis (increased or decreased)
Increased
41
What valvular lesion does the pressure volume loop represent?
Aortic stenosis
42
What is pulsus tardus?
Slower systolic upstroke on arterial waveform
43
What is pulsus parvus?
Narrow pulse pressure with small amplitude waveform on arterial line tracing
44
Effects of aortic insufficiency on the left ventricle
Volume overload Eventual eccentric hypertrophy
45
Etiologies of aortic regurgitation
Incompetent valve Dilation of the aortic root/ supporting structures
46
What conditions should be avoided in aortic regurgitation?
Bradycardia Increased SVR Large valve orifice
47
How is cardiopulmonary bypass approach different in patients with aortic regurgitation?
Cardioplegia must be injected retrograde (through coronary sinus) or directly into each coronary ostia
48
What are causes of acute aortic insufficiency?
Endocarditis (most common) Aortic root dissection from aneurysm or trauma
49
What is the pathophysiology of acute aortic insufficiency?
LV becomes acutely dilated > increased wall tension > LV failure > rapid cardiovascular instability
50
What conditions are associated with aortic insufficiency?
Valvular calcification Marfan syndrome Ehler-Danlos syndrome Ankylosing spondylitis
51
Heart rate goal for aortic insufficiency
Increased
52
Preload goal for aortic insufficiency
Maintain/ increase
53
Contractility goal for aortic insufficiency
Maintain
54
SVR goal for aortic insufficiency
Decrease
55
Pulmonary vascular resistance goal for aortic insufficiency
Maintain
56
What valvular lesion is associated with a sharp upstroke, low diastolic pressure, and wide pulse pressure on the arterial waveform?
Aortic insufficiency
57
What valvular lesion may have this arterial waveform tracing?
Aortic insufficiency
58
What valvular lesion may have this arterial waveform tracing?
Aortic stenosis
59
What valvular lesion does the pressure volume loop represent?
Chronic aortic regurgitation
60
What valvular lesion does the pressure volume loop represent?
Mitral stenosis
61
Normal area of the mitral valve orifice
4-6 cm2
62
Area of mitral valve orifice in severe mitral stenosis
<1 cm2
63
Quantitative indications of severe mitral stenosis
Transvalvular pressure gradient >10 mmHg Pulmonary artery systolic pressure >50 mmHg
64
Most common causes of mitral stenosis
Rheumatic fever (developing nations) Endocarditis (United States) Calcification of the mitral annulus secondary to atherosclerosis (United States)
65
Etiologies of mitral stenosis
Rheumatic fever Endocarditis Calcification of the mitral annulus secondary to atherosclerosis Rheumatic arthritis Systemic lupus erythematosus Congenital defect Left atrial myxoma Carcinoid syndrome Iatrogenic following mitral valve repair
66
What valvular lesion does the pressure volume loop represent?
Mitral stenosis
67
The image depicts the pathophysiology of which valvular lesion
Mitral stenosis
68
Heart rate goal for mitral stenosis
Slower end of normal
69
Preload goal for mitral stenosis
Maintain
70
Contractility goal for mitral stenosis
Maintain
71
SVR goal for mitral stenosis
Maintain
72
Pulmonary vascular resistance goal for mitral stenosis
Avoid increase
73
Regional anesthesia considerations for mitral stenosis
Pts are prone to atrial fibrillation and may be anticoagulated. Avoid neuraxial anesthesia in pts with INR >1.5
74
What valvular lesion does the pressure volume loop represent?
Chronic mitral regurgitation
75
The image depicts the pathophysiology of which valvular lesion
Mitral regurgitation
76
Etiologies of mitral insufficiency
Rheumatic fever Ishcemic heart disease Papillary muscle dysfunction Ruptured chordae tendineae Endocarditis Mitral valve prolapse Left ventricular hypertrophy Systemic lupus erythematosus Rheumatoid arthritis Carcinoid syndrome
77
Mitral insufficiency results in:
Volume overload Eccentric hypertrophy (left atrium)
78
Conditions to avoid in mitral insufficiency
Slow heart rate Increased pressure gradient between the LV and LA Increased SVR Increased size of valve orifice
79
Heart rate goal in mitral insufficiency
Increased (NSR)
80
Preload goal in mitral insufficiency
Maintain or increase
81
Contractility goal in mitral insufficiency
Maintain
82
SVR goal in mitral insufficiency
Decrease
83
Pulmonary vascular resistance goal in mitral insufficiency
Avoid increase
84
Systolic murmurs
Aortic stenosis Mitral regurgitation
85
Diastolic murmurs
Aortic regurgitation Mitral stenosis
86
Characteristics of aortic stenosis assessment
Auscultated at right sternal border through aorta and carotid arteries May be confused with bruit May be palpated as a thrill May decrease with severity
87
Characteristics of aortic regurgitation assessment
High pitch blowing murmur Auscultated at right sternal border
88
Characteristics of mitral stenosis assessment
Opening snap followed by low intensity rumbling murmur Auscultated at the apex and left axilla
89
Characteristics of mitral regurgitation assessment
Holosystolic murmur- loud swishing sound Auscultated at apex and left axilla
90
The three surgical approaches for transcatheter aortic valve replacement
Transfemoral Transaortic Transapical (antegrade)
91
Benefits of transcatheter aortic valve replacement
Sternotomy not required Cardiopulmonary bypass not required
92
Most common valves used for transcatheter aortic valve replacement
Edwards SAPIAN Medtronic CoreValve
93
Type of artificial valve that requires balloon valvulosplasty
SAPIAN
94
Type of artificial valve that requires rapid ventricular pacing
SAPIAN
95
Considerations for rapid ventricular pacing
Profound hypotension during pacing Ensure MAP >75 mmHg before pacing Have radiotranslucent pads on pt prior to pacing Keep pt apneic during pacing
96
Self-expanding artificial valve
CoreValve
97
Improper artificial valve deployment symptom
Acute aortic insufficiency
98
Surgical treatment for improper artificial valve deployment
SAPIAN- place another SAPIAN valve through malpositioned valve (valve-in-valve procedure) CoreValve- retrieve and redeploy
99
Complications fo transcatheter aortic valve replacement
Vascular injury (hemorrhage) Coronary occlusion Annular rupture (cardiac tamponade> cardiovascular collapse) Stroke Perivalvular leak Pericardial tamponade AV block LBBB 3rd degree block if pt has preexisting RBBB

Cardiac (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions